Cavalcanti Aracele Tenório de Almeida e, Medeiros Zulma, Lopes Fábio, Andrade Luiz Dias de, Ferreira Valéria de Melo, Magalhães Vera, Miranda-Filho Demócrito de Barros
Universidade de Pernambuco, Boa Vista, Recife, PE, Brazil.
Rev Inst Med Trop Sao Paulo. 2012 Jan-Feb;54(1):43-7. doi: 10.1590/s0036-46652012000100008.
HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.
与HIV/AIDS相关的内脏利什曼病可能呈现出侵袭性疾病的特征，也可能毫无特异性症状，因此诊断困难。本研究描述了对巴西伯南布哥州转诊医院收治的一系列HIV感染/AIDS患者中疑似内脏利什曼病（VL）病例进行诊断检测的结果。在总共14例有血细胞减少和/或不明原因发热且有骨髓穿刺指征的合格患者中，选择了10例纳入研究。通过以下检查确诊：骨髓穿刺液中利什曼原虫检测、直接凝集试验、间接免疫荧光、rK39试纸条检测、聚合酶链反应和乳胶凝集试验。10例患者中有5例被诊断为合并感染。所有5例合并感染患者的直接凝集试验均呈阳性，4例患者的利什曼原虫检测和乳胶凝集试验呈阳性，3例患者的rK39试纸条检测呈阳性，2例患者的间接免疫荧光呈阳性，1例患者的聚合酶链反应呈阳性。这一系列病例是巴西首次使用这套检测方法来检测合并感染。然而，迄今为止，对于该组患者的筛查和监测最合适的检查方法尚未达成共识。
